Update on Imaging of Ovarian Cancer (imaging/overview/open access)

open access

 

...This review will focus on the most common cancer type, epithelial ovarian cancer (EOC). The other primaries including germ cell and sex-cord stromal cell ovarian cancer are extremely rare (<5 %) and differ in many aspects, but share the same staging classification with EOC [5, 6]. An update of recent advances regarding EOC will be provided with special emphasis on their impact on clinical radiological practice.

New Insights in Ovarian Cancer Biology

The concept of ovarian cancer as a single disease has been revised. Epithelial ovarian cancer is now understood as a subsumption of diverse cancer entities that vary significantly clinically as well as pathologically and on a molecular level [7–9]. It comprises the following main cancer subtypes:

• high-grade serous,
• low-grade serous,
• endometrioid,
• clear cell and
• mucinous ovarian cancer [6, 11].

Differentiation of these subtypes is pivotal with regards to several aspects, such as biomarkers, precursor lesions, clinical presentation at diagnosis, prognosis, and response to treatment [5–11] (Table 1). Furthermore, considerable heterogeneity even within the same epithelial ovarian cancer subtype has been identified on a macroscopic and molecular level. This has also been attributed to the dedifferentiation within different implants of the same primary and thus the problem of tumor recurrence after initial response to therapy [3, 12].....